Sheila R Dickerman, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9105799 Issued in FL

Practice address

23 North St Ste 2
Presque Isle, ME 04769-2295

Phone

(207) 760-9278

NPI assigned

May 27, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Sheila Obradovich Former name

Medicare fee-for-service enrollment

Enrolled in FL, ME2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Leavitt Medical Associates of Florida Inc

  • Dermatology Physician
  • Sebastian, FL
  • NPI 1083872535
  Medicare reassignment NPD
• Emergency Medicine Services of Maine, LLC

  • Emergency Medicine Physician
  • Ellsworth, ME
  • NPI 1578032058
  Medicare reassignment
• Leavitt Medical Associates of Florida Inc

  • Dermatology Physician
  • Ocala, FL
  • NPI 1952534182
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1104119874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2546 MIDDLETON GROVE DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114784",
            "telephone_number": "813-781-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 NORTH ST STE 2",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047692295",
            "telephone_number": "207-760-9278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERMAN",
        "first_name": "SHEILA",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-27",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105799",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2079",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013054000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHEILA",
            "last_name": "OBRADOVICH",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ruby-Ann R Degenhardt, MHRT-CSP
• Lori L. Demerchant, LCSW
• Danielle Desjardins, APRN-CNP
• Norma J Desjardins, DMD
• Rebecca Dias
• Meghan Leigh Dinneen, FNP-C
• Discovery House WC, Inc.
• Crystal M Doherty
• Josee Doiron Tardif, RD, LD
• Donald R. Blackstone, D.M.D., PA

• Physician Assistant in Presque Isle, ME
• Providers in Presque Isle, ME by specialty
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.